Changes to TRICARE disenrollment coming in 2018TRICARE is changing. Are you ready? by: TRICARE.mil Staff
As part of the changes coming to TRICARE on Jan. 1, 2018, there will be new rules affecting disenrollment. Beginning in 2018, if you’re eligible for TRICARE and enrolled in a health plan, there are three ways you can be disenrolled:
- If you no longer wish to continue TRICARE coverage, you can voluntarily disenroll.
- If you fail to pay enrollment or premium fees.
- If you or your sponsor lose TRICARE eligibility.
On Jan. 1, 2018, TRICARE Standard will transition to TRICARE Select. Under TRICARE Select Starting on January 1, 2018, TRICARE Select replaces TRICARE Standard and Extra A fee-for-service option in the United States that allows you to get care from any TRICARE-authorized provider.TRICARE Standard and Extra. TRICARE Select is a self-managed, preferred provider network plan.
TRICARE Select, beneficiaries will need to be enrolled if they wish to use the program, and disenroll if they no longer wish to use this health plan. In order to disenroll from TRICARE Select, you will need to fill out a change form.
This is different from the current disenrollment process. Currently, you can disenroll or be disenrolled from TRICARE Prime and TRICARE Premium Based Plans (TRICARE Young Adult A premium-based plan for qualified adult children. TRICARE Young Adult (TYA), TRICARE Retired ReserveA premium-based plan for qualified Retired Reserve members and their families. TRICARE Retired Reserve (TRR), TRICARE Reserve SelectA premium-based plan for qualified Selected Reserve members and their families. TRICARE Reserve Select(TRS), US Family Health PlanA Prime option available through networks of community-based, not-for-profit health care systems in six areas of the U.S.US Family Health Plan (USFHP)), but you can’t be disenrolled from TRICARE Standard. Today, if you disenroll or are disenrolled from TRICARE Prime A managed care option available in Prime Service Areas in the United States; you have an assigned primary care manager who provides most of your care.TRICARE Prime, then you’re still automatically covered by TRICARE Standard. Once TRICARE Standard transitions to TRICARE Select, you will not have this automatic coverage—you must actively enroll.
Reenrollment After Disenrollment & Access to Care
You may elect to disenroll from any TRICARE plan at any time. During calendar year 2018 (Jan. 1-Dec. 31), you’ll have a full-year grace period to enroll or re-enroll in TRICARE Prime or TRICARE Select at any time, as long as you remain eligible. Special rules will apply in 2018 for beneficiaries who are eligible for TRICARE, but aren’t enrolled in a plan. These grace period rules include:
Your first episode of care from a civilian network provider will be covered by TRICARE.
You’ll have an opportunity to enroll or re-enroll.
If you don’t enroll at that time, you’ll only be able to receive care at a military hospital or clinic on a space-available basis and use military pharmacies. You’ll be responsible for all subsequent costs for seeing a civilian provider. TRICARE won’t pay any other claims.
The grace period doesn’t apply to premium-based plans.
Beginning Jan. 1, 2019, once you voluntarily disenroll from TRICARE Prime or TRICARE Select, you can only re-enroll if you experience a qualifying life event (QLE) or during the next annual open enrollment season (and receive coverage beginning Jan. 1).
If you disenroll or are disenrolled from a premium-based plan like TRR, TRS or TYA, you must wait 12 months and requalify for TRICARE if you want to purchase coverage again. If you disenroll from the Continued Health Care Benefit Plan (CHCBP), you can’t enroll in another TRICARE plan unless you become eligible for TRICARE again. Specific procedures and disenrollment forms are available online.
In cases of disenrollment due to loss of sponsor eligibility, you may be eligible for temporary coverage through the Transitional Assistance Management Program (TAMP).
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Breast reconstruction can aid psychological healingArmy Lt. Col. Owen Johnson III, a plastic surgeon at William Beaumont Army Medical Center at Fort Bliss, Texas, discusses options available for reconstructive surgery with a patient. (U.S. Army photo by Marcy Sanchez) by: Military Health System Communications Office
More breast cancer patients are becoming breast cancer survivors. But that survival sometimes comes at the cost of losing part or all of a breast – sometimes both breasts. That’s where reconstructive surgery comes in.
“After a mastectomy, breast reconstruction restores form,” said Air Force Maj. Justin Fox, a plastic surgeon at Wright-Patterson Air Force Base, Ohio. “There are several studies that say this helps in psychosocial and sexual well-being, all of which are part of any cancer treatment. It’s not just about the appearance and form, but also the psychological well-being of the patient.”
Fox said breast reconstruction as a part of cancer care is one of the few procedures backed by national health care policy, which requires TRICARE and insurance companies to provide reconstructive services.
“It’s not to enhance someone’s appearance or cup size,” he said. “It’s to restore them to as close as possible to where they were before a mastectomy.”
Fox said the options for having reconstructive surgery are explained when doctors talk with patients about their overall cancer treatments.
“I talk with them after their oncologist or cancer surgeon discusses what might need to be done, sometimes even before the patients have decided which surgery they will have,” he said. A lumpectomy is removing the diseased portion of the breast; a mastectomy is removing the entire breast.
“I start by telling patients that even if they have just a portion of the breast tissue removed, the plastic surgeon can play a role,” Fox said.
Lt. Col. Michelle Nash, branch chief at the Air Force Research Laboratory at Wright-Patterson, had a double mastectomy after being diagnosed with breast cancer earlier this year.
“At one point after my diagnosis, I remember thinking, why do I need reconstructive surgery? But after considering it, I decided not having it would be a difficult thing to deal with,” she said. “For me, getting reconstructive surgery was the right thing to do.”
Fox said there are options for breast reconstruction besides the use of implants. “[Patients] can use their own tissue from their abdomen, back, or inner thigh to re-create the breast,” he said.
Nash said she’s on the thinner side, so implants were a better option for her. The procedure began during her mastectomy. After the general surgeon removed her breast tissue, Fox placed expanders between her skin and chest muscles. The expanders have ports.
A few weeks after her surgery, Nash began going to Fox’s office weekly for saline injections. Fox adds more each time so that eventually, Nash’s skin will have stretched enough to accommodate the implants. The total amount of saline she’ll receive is based on the amount of breast tissue that was removed.
“I’m OK with the small cup size I had before my mastectomy,” Nash said. “I wasn’t looking for an upgrade.”
About a month after her “final fill,” Nash will have surgery to replace the saline with the implants.
“It’s a slow, gradual process,” Nash said. “And it’s been uncomfortable at times. But I have a very supportive work environment, and I’ve been able to do half-days at home, or take time off, when I haven’t felt well enough to go into work.”
Fox said patients don’t have to decide right away what they want to do about reconstructive surgery. “I believe you have better results if you do reconstruction immediately,” Fox said. “But there’s usually no time limit. A woman can come in a year or even five years later, and ask about her options.”
“The options may be different, depending on her cancer treatment,” Fox said. “But in my mind, there’s never a point where I would tell them they’ve waited too long.”
Online patient portal saves time, improves access to medical informationThe TRICARE Online Patient Portal connects registered users with online health care information and services at military hospitals and clinics. by: Military Health System Communications Office
Air Force Maj. Stephanie “Jill” Raps is a busy nurse. Before departing for advanced schooling at the Uniformed Services University of the Health Sciences, Raps was assigned to the Defense Health Agency where she developed digital tools to help patients, doctors, and other health care providers access information in the Military Health System. Raps spends her “free” time chasing around a 2 year old and a 4 year old. One evening as she waited outside her older daughter’s ballet class, she remembered she needed to make an appointment for a physical for her daughter’s day care.
“I looked at my watch and realized, ‘Shoot, the appointment line just closed!’” said Raps.
Air Force Maj. Stephanie Raps uses her smartphone to access the TRICARE Online Patient Portal.Rather than wait to call the next day – or worse, forget to call at all – Raps used her smartphone to access the TRICARE Online Patient Portal, also called TOL Patient Portal, a secure website that connects registered users with online health care information and services at military hospitals and clinics.
“You can access the [TOL] Patient Portal with any device, including your smartphone,” said Army Col. Richard Wilson, a division chief in the Health Information Technology directorate at the Defense Health Agency. “Users can manage appointments for themselves and their authorized family members.”
Wilson believes patients who can more easily access their own health information using TRICARE Online will be more inclined to use the health benefit.
”Beneficiaries can use the service 24 hours a day, seven days a week, instead of trying to call and book appointments at times that might not be the most convenient for our beneficiaries,” said Wilson. “This makes our patients better engaged in their own health care, which tends to produce better health outcomes.”
To access the mobile TOL Patient Portal, beneficiaries will need to register for a Department of Defense Self-Service (better known as DS) Logon account through the Defense Manpower Data Center.
The TOL Patient Portal also has a mobile prescription refill function. Soon, another feature will be activated that will provide patient access to personal health information, such as lab results, vital signs, and immunizations, to name a few.
“What we really want patients to realize is they have these awesome tools out there,” said Wilson, “that speed things up, help them become more informed, and ultimately, let them be more healthy and have a better quality of life.”
Using the mobile access of the TRICARE Online Patient Portal when it was convenient for her, Raps quickly made her daughter’s appointment while avoiding the hassle of making a phone call during limited hours, and saving time, a commodity she values greatly.
“At the end of the day, the most important thing for a military member is time. We just don’t have a lot of time,” said Raps. “This access gives me information and the time I need.”
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